What is urinary incontinence?

Millions of women experience involuntary loss of urine called urinary
incontinence (UI). Some women may lose a few drops of urine while running or
coughing. Others may feel a strong, sudden urge to urinate just before losing a
large amount of urine. Many women experience both symptoms. UI can be slightly
bothersome or totally debilitating. For some women, the risk of public
embarrassment keeps them from enjoying many activities with their family and
friends. Urine loss can also occur during sexual activity and cause tremendous
emotional distress.

Women experience UI twice as often as men. Pregnancy and childbirth,
menopause, and the structure of the female urinary tract account for this
difference. But both women and men can become incontinent from neurologic
injury, birth defects, stroke, multiple sclerosis, and physical problems
associated with aging.

Older women experience UI more often than younger women. But incontinence is
not inevitable with age. UI is a medical problem. Your doctor or nurse can help
you find a solution. No single treatment works for everyone, but many women can
find improvement without surgery.

Incontinence occurs because of problems with muscles and nerves that help to
hold or release urine. The body stores urine-water and wastes removed by the
kidneys-in the bladder, a balloon-like organ. The bladder connects to the
urethra, the tube through which urine leaves the body.

Figure 1. Front view of bladder and sphincter muscles

During urination, muscles in the wall of the bladder contract, forcing urine
out of the bladder and into the urethra. At the same time, sphincter muscles
surrounding the urethra relax, letting urine pass out of the body. Incontinence
will occur if your bladder muscles suddenly contract or the sphincter muscles
are not strong enough to hold back urine. Urine may escape with less pressure
than usual if the muscles are damaged, causing a change in the position of the
bladder. Obesity, which is associated with increased abdominal pressure, can
worsen incontinence. Fortunately, weight loss can reduce its severity.